How survey design affects self-assessed health responses in the Survey of Health, Ageing, and Retirement in Europe (SHARE)

•This paper shows that responses to self-assessed health questions exhibit question order and framing effects.•We examine the amount of concordance between responses to different self-assessed health questions.•Word and numerical concordance depend on observable characteristics.•We corroborate others' findings for the UK by extending the results to 11 additional European countries.

This paper considers the role of question order and framing in evaluating subjective health assessment responses using the Survey of Health, Ageing and Retirement in Europe (SHARE) dataset. In the first wave of this dataset respondents were twice asked to evaluate their health on a five-point scale, using two different sets of descriptors to define the five points, with the ordering of which set was first administered determined randomly. We document differences in inference in comparing those that were asked one question first versus those that were asked the other. We then consider determinants of the degree of concordance in responses to the two questions, as well as the characteristics of individuals that provide conflicting responses. Consistent with previous research for England (Bowling and Windsor, 2008. Journal of Epidemiology and Community Health 62, 81-85), there is evidence for eleven countries in Europe that individuals' assessments of their health in response to the second question may be influenced by the battery of health questions that were asked following the first assessment.